珂立苏联合鼻塞持续气道正压通气治疗新生儿呼吸衰竭的临床研究

Clinical trial of Kelisu combined nasal continuous positive airway pressure for neonatal respiratory ailure

目的探讨牛肺泡表面活性剂(珂立苏)联合鼻塞持续气道正压(NCPAP)治疗新生儿呼吸衰竭的临床疗效与安全性。方法选取2016年在本院新生儿科收治的48例呼吸衰竭患儿为研究对象,根据随机数表法将48例患儿分为2组,每组均为24例:试验组和对照组。试验组患儿服用珂立苏70~100mg·kg^(-1)联合NCPAP治疗;对照组单用NCPAP治疗。比较使用珂立苏后0,6,12,24 h时患儿的呼吸功能指标、动脉血气指标变化情况,治疗后转归及药物不良反应(ADR)发生率。结果治疗后12 h,试验组的PaO_2水平(75.7±1.6)mm Hg明显高于对照组的(70.8±1.8)mm Hg;试验组的PaCO_2水平(51.2±1.7)mm Hg明显低于对照组的(53.8±0.7)mm Hg;试验组的总氧疗时间(180.65±21.64)h明显低于对照组的(217.52±19.58)h;试验组的ADR发生率16.7%(4例/24例)明显低于对照组的45.8%(11例/24例),2组间的上述指标比较,差异均有统计学意义(均P<0.05)。结论珂立苏联合NCPAP可明显提高呼吸衰竭患儿的治疗效果,安全性良好。

Objective To evaluate the effect of calf pulmonary surfactant（ Kelisu） combined nasal continuous positive airway pressure（ NCPAP） in the treatment of neonatal respiratory failure（ NRF）.Methods Forty-eight NRF in our hospital were selected,and divided into the control group（ n = 24） and the treatment group（ n = 24） according to random number table. Control group were given NCPAP therapy,treatment group were treated with Kelisu 70-100 mg · kg^-1 combined NCPAP. After using Kelisu 0,6,12,24 h,the results of arterial blood gas analysis,respiratory function indexes,clinical effects and incidence of complications in the two groups were compared. The adverse drugs reaction（ ADR） were investigated. Results After 12 h treatment,the level of PaO2 in treatment group with（ 75. 7 ± 1. 6） mm Hg was higher than the control group with（ 70. 8 ± 1. 8） mm Hg. The level of PaCO2 in treatment group with（ 51. 2 ± 1. 7） mm Hg was lower than the control group with（ 53. 8 ± 0. 7） mm Hg. The time of the oxygen curein in treatment group with（ 180. 65 ± 21. 64） h was shorter than the control group with（ 217. 52 ± 19. 58） h. The incidence of ADR in treatment group with16. 7%（ 4 cases/24 cases） was lower than the control group with 45. 8%（ 11 cases/24 cases）. Camparison between control group and the treatment group on the factors,the differences were statistically significant（ all P〈0. 05）. Conclusion Endotracheal dripping of calf pulmonary surfactant combined with NCPAP is an effective treatment for NRF,and had good safety.